Wl 


^ -t 


VV-;  jT  r . ■ 

1*:5  Ensr  o Kt-er 


Medical  Mission  Series 


■<K  ClfY 


l3°io 


HOSPITALS  IN  SIAM 

1.  Southern  Siam 

2.  The  Laos 


New  Hospital,  Nakawn 


The  Woman's  Foreign  Nissionarg  Society 
of  the  Presbyterian  Church 
501  Witherspoon  Building,  Philadelphia 


1905 


HOSPITALS  AND  DISPENSARIES 
1Q05 


Southern  Siam. 

Bangkok. — Medical  itineration. 

Lucius  C.  Bulkley.  M.  D. 

Petchaburi. — Hospital ; dispensary. 

E.  B.  McDaniels,  M.  D. 

Ea JABURI. — Hospital ; dispensary. 

Rev.  Egon  Wachter,  M.  D. 

Xakaivn. — Hospital ; dispensary. 

W.  J.  Swart,  M.  D. 

PiTSANULOKE.^ — Hospital ; dispensary. 

Carl  J.  Shellman,  M.  D. 

Laos. 

Chieng  Mai. — Hospital;  dispensary. 

Lampoon  (sub-station) . — Dispensary. 

James  W.  McKean,  M.  D.  ; Claude  W.  Mason,  M.  D. 
Lakawn. — Hospital ; dispensary. 

C.  C.  Hansen,  M.  D. 

Nan. — Hospital ; dispensary. 

Rev.  S.  C.  Peoples,  M.  D. 

Pre. — Hospital ; dispensary. 

Chieng  Eai. — Hospital;  dispensary;  twenty  branch  dispen 
saries  in  villages. 

Rev.  W.  a.  Briggs,  M.  D.  ; Charles  H.  Crooks,  M.  D. 
Total  number  of  patients  treated  (1907)  57,062. 


We  are  indebted  to  the  kindness  of  W.  A.  Briggs,  M.  D. 
for  much  of  the  information  contained  in  this  leaflet. 

2 


HOSPITALS  IN  SIAM 


EDICAL  MISSION  work  in  Siam  began  in  1835 
with  the  arrival  of  Dr.  Daniel  B.  Bradley,  a 
missionary  of  the  American  Board.  Dr.  Bradley 
was  a man  of  remarkable  skill  and  ability,  and 
remained  in  Siam  after  his  Board’s  work  there 
was  given  up,  devoting  himself  to  the  welfare 
of  the  Siamese  until  his  death  in  1873.  Eev.  S.  E.  House, 
M.  D.,  the  first  physician  sent  by  the  Presbyterian  Church, 
arrived  in  1847. 

During  the  first  critical  years  of  the  Mission,  the  medical 
work  was  the  chief  means  of  allaying  the  natural  prejudice 
felt  against  the  foreigners  and  gaining  toleration  from  the 
old  king.  Since  the  accession  of  King  Chulalongkorn  in  1868, 
American  missionary  physicians  have  been  the  trusted  ad- 
visers of  the  government  in  its  efforts  to  introduce  scientific 
medical  practice.  With  the  gradual  increase  of  intelligence 
the  new  generation  has  come  to  recognize  to  some  extent  the 
efficiency  of  modern  methods  and  especially  the  benefits  of 
surgical  skill.  The  king  has  established  in  Bangkok  army  and 
navy  hospitals,  two  hospitals  for  citizens,  an  insane  asylum 
and  a Eoyal  School  of  Medicine.  All  these,  with  one  or  two 
exceptions,  are  in  charge  of  medical  missionaries,  or  of  those 
who  have  at  some  time  been  connected  with  the  missionary 
work.  The  crown  prince,  who  was  educated  in  England,  has 
asked  several  missionary  physicians  to  write  theses  on  hygiene 
and  the  most  prevalent  diseases  to  serve  as  a basis  for  sani- 
tary measures  to  be  brought  before  the  government.  But 

3 


the  spread  of  western  ideas  is  confined  as  yet  to  a very 
narrow  circle,  and  the  masses  of  the  people,  both  in  city  and 
country,  are  content  to  live  and  die  in  the  unsanitary  tra- 
ditions of  their  forefathers. 

We  have  no  organized  medical  work  in  Bangkok.  Rev. 
Eugene  P.  Dunlap,  D.  D.,  though  not  a professional  2)hysician, 
has  relieved  much  suffering  in  his  itinerating  trips  by  land 
and  sea  along  the  shores  of  the  Gulf  of  Siam  and  through 
the  peninsular  provinces.  In  such  tours  recently  made  by  Dr 
Dunlap  and  Lucius  C.  Bulkley,  M.  D.,  over  one  thousand 
patients  were  treated  and  many  operations  performed,  be- 
sides thousands  of  vaccinations.  Dr.  Bulkley  says: 

The  high  commissioner  of  Pooket,  grateful  for  his  own  recovery 
from  serious  illness,  offered  to  build  hospitals  at  two  places  if 
missionaries  CQuld  be  sent.  “I  want  a missionary  doctor,”  he  said, 
“because  I know  how  much  deeper  interest  he  will  take  in  the  sick 
than  an  ordinary  doctor.  Come  start  hospitals  and  schools  and  I will 
see  that  money  is  secured  to  help  support  them,  and  I will  also  aid 
you  in  going  about  to  preach  to  the  people.”  His  excellency  has  since 
purchased  land  and  drawn  up  plans  for  the  first  hospital  at  Tap 
Tiang.  an  important  market  town. 

At  Panga,  for  a cripple  who  had  been  bitten  by  a crocodile, 
we  made  a pair  of  crutches,  the  first  ever  seen  in  that  region.  What 
a change  it  made  in  his  life!  From  lying  helpless  on  his  back  for 
seven  years  he  was  now  an  active  and  independent  member  of  the 
community — even  his  name  was  changed  from  “Dog”  to  “Happy.” 
He  was  baptized,  with  his  mother,  on  Dr.  Dunlap’s  arrival. 

Each  of  the  four  provincial  mission  stations  in  Siam, 
Petehaburi,  Rajaburi,  Pitsanuloke  and  Nakawn,  has  now  a 
good  hospital  and  dispensary,  with  a resident  physician.  In 
all  these  places  land  was  given  by  the  king  or  rented  at  a 
nominal  price,  and  generous  gifts  made  for  the  buildings. 
The  women’s  ward  at  Petehaburi  was  given  by  the  queen. 
These  stations  are  all  centers  for  wide  itinerating  work. 
Rajaburi  and  Petehaburi  are  now  connected  with  Bangkok  by 
rail,  which  makes  it  easier  to  obtain  supplies  and  saves  much 
time  in  travel. 

The  beautiful  hospital  at  Pitsanuloke,  255  miles  north 
of  Bangkok,  is  the  only  one  in  that  region.  It  was  given 
by  the  high  commissioner  as  a memorial  to  his  mother,  and 

4 


built  and  equipped  with  modern  apparatus  by  Dr.  Toy’s 
energetic  efforts.  Though  only  three  years  old,  this  hospital 
of  fourteen  beds  is  already  too  small.  The  physician  in 
charge  rejoices  in  an  excellent  Siamese  assistant,  thoroughly 
sympathetic  and  useful.  On  a recent  tour  over  one  thousand 
six  hundred  children  were  vaccinated.  The  governor  of  the 
province  was  so  pleased  with  this  service  that  he  offered  to 
pay  all  expenses  of  the  trip. 

Nakawn,  five  hundred  miles  south  of  Bangkok,  occupies 
a field  of  its  own  as  the  center  of  influence  in  its  province. 
In  1883  an  invalid  gentleman  of  Nakawn  started  in  a sailboat 
with  his  wife  to  consult  the  ‘ ‘ foreign  doctor  ’ ’ at  Bangkok. 
The  little  boat  was  driven  by  the  wind  into  the  harbor  of 
Petchaburi.  “Why  go  to  Bangkok?’’  said  the  people.  “Here 
at  Petchaburi  is  a foreign  doctor  who  can  almost  make  the 
dead  to  live ! ’ ’ The  strangers  made  their  way  to  the  hospital ; 
the  man  was  cured  of  his  illness  and  both  he  and  his  wife 
became  Christians  before  returning  home.  Through  their  in- 
fluence missionaries  were  sent  to  Nakawn  and  a church  organ- 
ized in  1895.  The  medical  work  has  always  been  important, 
and  in  T907  a beautiful  hospital  was  completed  and  opened 
through  Dr.  Swart’s  exertions.  The  entire  cost  was  twenty- 
four  thousand  ticals  ($8,000  gold),  of  which  three  fourths  was 
given  in  Siam. 

All  these  hospitals  are  self-supporting,  except  for  the 
salaries  of  the  physicians  in  charge. 

The  prevalent  diseases  in  Siam  are  cholera,  dysentery  and 
malarial  fevers — all  transmitted  by  infected  water  or  abundant 
insect  life.  In  Bangkok,  while  the  climate  is  not  more  un- 
wholesome than  that  of  other  tropical  cities,  the  question  of 
water  is  a very  serious  one.  There  is  practically  no  rain 
for  six  months  of  the  year ; there  are  no  wells  or  springs ; 
the  only  natural  supply  comes  from  the  filthy  river  and 
canals,  which  serve  as  bath  tubs,  wash  tubs  and  sewers  for  the 
city.  The  masses  drink  the  river  water,  with  the  natural 

5 


results.  The  onlj"  alternative  is  that  adopted  by  most  of 
the  well-to-do  peoi)le — to  gather  and  store  the  rain  water  that 
falls  in  the  wet  season.  This  has  to  be  done  with  the  greatest 
care  and  the  supply  kept  in  covered  earthen  jars  or  some- 

times in  great  iron  tanks,  which  are  carefully  locked  for  fear 
of  robbers.  The  stored  water  must  be  further  purified  by 
boiling  or  filtering  before  it  is  safe  for  drinking.  A small 
family  requires  a store  of  about  eight  hundred  gallons.  One 
may  imagine  the  expense  and  vigilance  needed  to  provide 
an  adequate  six  months’  supply  for  a large  school  or  hospital. 

The  natives  have  a great  dread  of  cholera,  which  they  call 

“the  hurricane,”  from  its  sudden  coming  and  swift  fatality,  and  fear 
to  mention  its  name.  A great  spirit,  th^^  say,  sits  with  his  feet 
in  the  fire  and  needs  many  servants  to  bring  mm  water.  All  those  whose 
bodies  are  not  burned  are  forced  to  serve  him.  Cremation  is  the 
general  custom  in  Siam,  but  is  forbidden  in  the  case  of  cholera 
victims  until  after  some  months.  Thus  the  spirit  has  all  those  that 
die  of  this  disorder.  After  a time  many  of  these  bodies  will  be 
taken  up  and  burned,  and  their  spirits  thus  delivered  from  their  hard 
master.  When  his  retinue  becomes  too  small,  he  sends  another 
epidemic  of  cholera  to  keep  up  the  number. 

In  times  of  epidemic  a tall  bamboo  pole  stands  in  front  of 

each  house,  from  which  float  gay-colored  flags  of  odd  shapes.  When 
the  first  cholera  patient  dies  in  Bangkok  his  hands  are  examined 

and  the  shapes  formed  by  the  intersecting  lines  on  the  palms  are 
carefully  traced.  From  these  the  Buddhist  priests  make  these  flags, 
which  the  people  buy  as  charms.  Upon  one  of  the  flags  the  names 
of  the  household  are  written,  and  at  night  a lantern  is  hung  from 
each  pole  so  that  the  evil  spirit  may  see  the  names  and  pass  by  the 
house. 

The  chief  dependence  of  the  native  practitioners  for  all  ail- 
ments is  upon  incantations  and  charms.  They  know  nothing  of 
surgery,  but  use  various  preparations  of  medicinal  herbs  and  roots, 
and  curious  medieval  compounds,  of  which  the  following  popular  cure 
for  all  kinds  of  fever  may  serve  as  an  example:  Take  equal  parts 
of  elephant’s  tusk,  tiger’s  teeth,  crocodile’s  teeth  and  bear’s  teeth; 
equal  parts  of  buffalo  horn,  rhinoceros  horn,  stag’s  horn  and 
sandalwood;  equal  parts  of  the  bones  of  a vulture,  a crow  and  a 
goose.  All  these  to  be  pulverized  and  mixed  on  a stone  with  pure 
water,  one  half  the  resulting  paste  swallowed  at  one  dose,  the  other 
half  rubbed  on  the  outside  of  the  body. 

Dried  rhinoceros  skin  is  sold  in  the  markets  in  hard,  black 
slabs  about  a foot  square,  at  one  dollar  a pound.  A tea  made  from 
the  parings  is  supposed  to  be  useful  in  cases  of  malaria.  For  wounds, 
one  remedy  is  a young  mouse  burnt  to  a cinder  and  tightly  bound  on. 

There  is  crying  necessity  every^vhere  for  sanitary  ami 
medical  reforms.  It  is  said  that  seventy-five  per  cent  of  the 
children  born  die  in  childhood  from  disease  or  lack  of  care, 

6 


and  in  some  districts  the  population  is  actually  decreasing. 
Smallpox  destroys  many  thousands  every  year.  Vaccination 
was  introduced  by  Dr.  Bradley,  who  had  to  hire  men  to 
undergo  it.  The  government  now  offers  it  free  to  all,  but 
it  is  yet  far  from  general. 


The  Laos  people,  occupying  the  northern  provinces  of 
Siam,  are  largely  spirit-worshipers  and  ascribe  all  diseases 
to  the  agency  of  demons.  The  pioneer  missionaries,  coming 
in  1867,  brought  with  them  the  blessings  of  healing  as  well 
as  teaching.  Dr.  McGilvary,  though  without  a physician’s 
title,  did  a physician’s  work  from  the  beginning.  He  intro- 
duced the  use  of  quinine  for  the  prevalent  malarial  fevers, 
even  hiring  people  at  first  to  take  it  and  prove  its  value. 
To-day  quinine  is  in  general  use,  and  has  saved  many  lives. 
Dr.  McGilvary  also  introduced  vaccination,  until  then  unheard 
of.  Dr.  M.  A.  Cheek,  Dr.  Vrooman  and  Dr.  Peoples  were 
the  earliest  physicians  commissioned.  Others  have  followed 
them  and  through  their  ministrations  prejudice  has  been 
broken  down  and  a hearing  gained  for  the  gospel. 

Five  stations — Chieng  Mai,  Lakawn,  Nan,  Chieng  Eai,  and 
Pre — now  have  hospitals  and  dispensaries,  all  self-supporting. 
At  Lampoon  a dispensary  is  maintained,  though  there  is  no 
resident  physician.  Thirty-five  thousand  patients  are  treated 
annually  by  these  hospitals.  Problems  in  this  region  are  in- 
tensified by  the  great  distance  from  the  base  of  supplies. 
When  deficiencies  can  only  be  made  up  by  a journey  of  three 
weeks  down  the  river  and  six  weeks  back,  it  behooves  the 
doctor  to  take  long  looks  ahead. 

Chieng  Mai,  the  capital  of  the  province,  has  an  excellent 
hospital  in  a spacious  compound,  with  a separate  pavilion  for 
foreigners.  One  unique  feature  here  is  a vaccine  laboratory, 
established  by  Dr.  McKean  on  account  of  the  impossibility 
of  obtaining  satisfactory  virus.  The  lymph  is  supplied  to 

7 


VACCINATING  STAFF,  CHIKNG  MAI  HOSPITAL 

These  Christian  men  have  vaccinated  more  than  ten  thousand  persons  and  have  carried  tlie  good  news  into 
many  villages  never  yet  reached  by  a missionary. 


the  government  employes  as  well  as  to  the  staff  of  the  hospital. 
A corps  of  140  Christian  men  are  employed  to  travel  through 
the  province  vaccinating  the  people  and  preaching  the  gospel. 
They  carry  with  them  quinine  and  simple  remedies,  and  also 
distribute  gospels  and  tracts.  Ten  thousand  persons  were 
recently  vaccinated  in  six  months.  A small  charge  is  made, 
of  which  the  operators  get  half,  which  supplies  their  expenses; 
the  rest  goes  to  the  hospital.  These  men  are  required  to  spend 
three  days  each  month  at  the  hospital  for  instruction,  and 
some  of  them  become  quite  skillful.  Even  with  this  partial 
training  they  are  infinitely  superior  to  the  native  spirit 
doctors. 

Dr.  McKean  says: 

“Among  many  reasons  for  gratitude  to  God,  I must  not  fail  to 
mention  our  three  long-tried  and  faithful  hospital  assistants.  Especially 
should  we  mention  our  head  nurse,  Dr.  Kao,  who  is  unwearied  in 
service  to  the  poor  and  distressed.” 

For  many  years  past  it  has  been  felt  that  there  was 
urgent  need  for  some  organized  work  for  lepers,  of  whom 
there  are  many  in  Siam.  Buddhism  has  done  nothing  for 
them  and  never  will.  According  to  Buddhist  belief,  lepers 
are  suffering  for  sins  committed  in  some  previous  existence, 
and  the  decrees  of  fate  must  not  be  thwarted.  As  the  loss 
of  parts  of  the  hands  and  feet  makes  any  kind  of  work  im- 
possible, begging  is  the  leper ’s  only  resource.  Hence  these 
unfortunate  creatures,  who  are  a menace  to  the  community, 
wander  about  in  all  public  places,  begging  for  food  to  keep 
life  in  their  poor  deformed  bodies. 

Dr.  McKean  says : 

“Ten  years  ago  we  began  to  represent  the  case  to  the  Bangkok 
government  and  have  often  asked  for  land  on  which  to  erect  a refuge. 
Now  his  excellency  the  governor  of  Chieng  llai  has  kindly  given  us 
for  the  purpose  half  of  an  island  in  the  river  near  Chieng  Mai,  and 
his  gift  has  been  ratified  by  royal  authority.  The  tract  of  land  is 
ideal  in  every  way.  It  comprises  i6o  acres,  most  of  it  suitable  for 
the  culture  of  rice,  which  is  the  chief  food  here.  It  has  lain  fallow 
for  years  because  it  was  the  forage  ground  for  the  governor’s  pet 
elephant,  which  was  so  vicious  that  no  one  dared  to  live  near  his 
haunts.  When  the  elephant  died  we  begged  earnestly  for  the  ground 

9 


and  the  governor  turned  it  over  to  us.  At  the  upper  end  stands 
a spreading  banyan  tree,  under  whose  branches  Dr.  and  Mrs.  Mc- 
Gilvary  moored  their  boats  and  spent  their  first  Sunday  when  they 
came  as  pioneers  to  Chieng  Mai,  forty-one  years  ago. 

“We  fervently  hope  and  believe  that  the  governor’s  gift  marks 
the  beginning  of  the  end  of  leprosy  in  Siam.  Careful  and  loving 
treatment  of  those  now  afflicted,  a practical  demonstration  of  the 
benefits  of  segregation,  and  the  growth  of  education  and  Christian 
sentiment  will,  we  trust,  bring  about  compulsory  segregation,  which 
in  the  course  of  time  will  stamp  out  the  disease  in  Siam  as  it  did 
in  Europe  centuries  ago.  In  the  meantime  the  Christian  church  should 
care  for  the  outcasts  and  also  give  them  the  gospel.  . . . Our 
present  crying  need  is  for  money  to  erect  suitable  buildings  where 
we  may  house  and  feed  our  outcast  friends — men  and  women  for 
whom  Christ  died,  and  for  whom  he  seems  to  have  felt  an  especial 
compassion.” 

At  Lakawn  (1885)  is  the  Van  Santvoord  Memorial 
Hospital,  to  which  a new  ward  for  women  and  children  was 
added  in  1906.  Not  a few  of  the  church  members  were 
brought  to  Christ  in  the  hospital.  Among  these  was  a young 
man  of  intellect  and  fine  character,  who  is  now  one  of  the 
best  teachers  in  the  boys’  school.  All  the  assistants  in  both 
hospital  and  dispensary  are  Christians,  so  that  a Christian 
influence  pervades  the  place. 

Four  days’  journey  southeast  of  Lakawn  is  the  station 
of  Pre  (1894)  in  a fertile  and  beautiful  valley.  Here  the 
hospital  work  has  been  done  in  temporary  structures  of  bam- 
boo, without  any  adequate  equipment.  There  is  just  now  no 
resident  physician. 

Nan  (1895)  is  a beautiful  walled  city  embowered  in  trees, 
eight  days  ’ journey  northeast  of  Lakawn.  The  mission 
property  is  situated  between  the  city  wall  and  the  Nan  River. 
A new  dispensary  recently  erected  is  admirably  adapted  to 
its  purpose.  There  are  three  large,  airy  rooms,  with  clinic 
and  storerooms,  and  a wide  veranda.  Dr.  Peoples  has  done 
much  for  the  Laos  people  in  his  twenty-five  years  of  de- 
voted service,  amid  all  the  anxieties  and  discouragements  of 
pioneer  medical  work  with  very  imperfect  appliances.  It  is 
hoped  that  the  new  dispensary  may  be  followed  some  day  by 
a hospital  of  sufficient  capacity  and  equipment  for  the 
growing  needs. 


10 


Chieng  Rai  (1897),  our  most  isolated  station  among 
the  Laos,  is  nine  days  by  jungle  trail  northeast  of  Chieng 
Mai.  The  American  mail  is  nearly  three  months  old  when  it 
reaches  the  lonely  mission  there.  The  city  lies  on  the  main 
route  of  trade,  drawing  custom  from  Indo-China  (French), 
the  South  Shan  States  (English),  and  Southern  China.  Dr.  C.  A. 
Denman  and  his  successor.  Dr.  W.  A.  Briggs,  have  built  up 
an  imjiortant  medical  work  at  Chieng  Rai  under  great  diffi- 
culties. Twenty  branch  dispensaries  are  maintained  in  the 
country  districts,  and  the  civil  and  police  departments  of  the 
local  government  draw  their  supplies  through  our  dispensary. 

The  great  need  for  new  buildings  will  be  relieved  on  the 
return  of  Dr.  Briggs  from  his  furlough,  by  the  erection  of  a 
memorial  hospital,  for  the  building  and  equipment  of  which 
$10,000  gold  has  been  given.  This  generous  provision  will 
relieve  the  physician  of  the  anxious  struggle  to  care  for  the 
suffering  with  no  adequate  means. 


The  remarkable  progress  of  Siam  in  civilization  during 
the  last  fifty  years ' is  second  only  to  that  of  Japan.  The 
responsibilities  laid  upon  those  who  have  stimulated  and 
guided  this  progress  are  well  stated  in  the  weighty  words 
of  the  Hon.  Hamilton  King,  Ltnited  States  Minister  to  Siam, 
in  an  address  recently  delivered  at  Bangkok : 

“The  missionaries  came  to  Siam  to  help  her  people.  They  found 
multitudes  dying  of  disease;  they  fought  cholera  with  cleanliness,  fevers 
with  quinine,  smallpox  with  vaccination.  . . . Now  Siam  has  changed. 
She  has  taken  long  steps  forward  in  fifty  years.  Things  are  no 
longer  in  their  beginnings.  From  the  introduction  of  quinine  and 
vaccination  have  developed  questions  of  national  sanitation  and  organ- 
ized medical  work.  Are  you  missionaries  who  planted  for  this  growth 
ready  to  help  develop  the  crop? 

“Siam  asks  you  to  do  your  part  in  shaping  the  medical  work 
of  the  nation;  to  stamp  it  with  the  best  known  to  Christian  medical 
science.  Anything  less  than  the  best  will  not  avail.  Medical  men 
are  needed  who  shall  come  from  the  best  schools  and  conduct  the 
best  hospitals  in  the  best  way.” 


Price,  3 cents;  30  cents  a dozen. 
11 


